Objective: The World Health Organization (WHO) developed the 'Strengthening Midwifery Toolkit' in response to an international emphasis on increasing midwifery's role in providing maternal newborn health services. It was used to assist a review of midwifery in Mongolia.
Method: A rapid situational assessment included site visits to eight health facilities and four educational institutions resulting in 30 key informant interviews and six focus group discussions (67 midwives and students). A desk review of pertinent documents (n= 19) was undertaken. Data collected included assessments of: midwife competency (n= 96), scope of practice (n= 2), health facilities (n= 8), educational institutions (n= 4), legislation and regulation (n= 1), and midwifery (n= 4) Feldsher-Nurse (n= 4) and Bachelor-Nurse (n= 1) curricula.
Findings: Stakeholders in Mongolia are committed to strengthening midwifery across the country to better align with international standards. This requires: a long-term investment in reorientating the health workforce and educational institutions, regulatory changes, educational investment, job description changes which will impact on other maternal newborn health service providers. Additional support and incentives for providers in rural and remote areas is needed and investment in health facilities to enable appropriate infection control; and adequate provision of essential equipment and drugs, are important strategies needed to protect staff. Maternity emergency training is required across the country.
Conclusion: The Midwifery Toolkit was adapted to suit the local context and provided an excellent framework for this review.